15 Tips to Cope with Social Anxiety | Live Chat with Dr. Dawn-Elise Snipes

Foreign. Everybody. And welcome to today's live presentation. We are going to be talking about social anxiety and obviously tips to cope with social anxiety because a lot of people have it and you know, it's really common in especially adolescence. But you know, a lot of people have diagnosable, if you want to put it that way, some social anxiety. So we're going to talk about what makes it diagnosable and some things you can do about it. Social anxiety is more than just shyness and it's different from introversion. People who are shy feel self conscious around others, but you know, they, they just kind of get embarrassed easily. So you want to think of that as like way over here on the spectrum of anxiety. People who are introverted are very, very different. Introversion is when somebody prefers to have some time alone or to be in groups of, you know, smaller groups of people because the input from noticing and reading other people is exhausting to people who are introverted. My husband and my daughter are both introverts and we, when they have to do things, even like going out shopping, going to the mall, going to, you know, Christmas parties, those things are extraordinarily exhausting for them. They don't necessarily dislike them, they enjoy getting to see other people, but those things are exhausting. And introverts need time to themselves every day to get regrounded, to kind of quiet the noise. Introverts are very aware of what's going on inside them, but they have to pay a lot more attention and use a lot more energy to read other people and know what's going on around them. Social anxiety, on the other hand. Now shyness and introversion, those are, you know, very common characteristics. Social anxiety is an intense, persistent fear of being watched and judged by others. Again, it's on a continuum. A lot of us feel a little bit of anxiety when we're getting ready to teach a class, give a speech, go in front of a group of people, we may have some anxiety about being watched or judged, but when it raise rises to this level of being intense and persistent, where wherever you go, it's almost debilitating, where it interferes with your activities of daily living, where it causes significant distress, especially to the point where you stop doing some things or avoid some things because it's so anxiety provoking, that's when we get to the level of quote, diagnosable. Now ultimately, you know my feeling, or you probably know my feeling if you've watched my other videos about diagnosableness. If we wait until it, something gets to the point of causing, quote, clinically significant distress, then we've missed a lot of opportunities for early intervention and prevention. If you feel fear of being watched and judged by others, whether it is minimal fear or major fear, but when you feel, it is the time to step in and to start trying to address it. So the question comes in the role of hormones on social behavior. And interestingly enough, there is a lot of research out there. But let's talk about, I guess, two of the more common or three of the more common hormones out there. The first one is oxytocin, and it's our bonding hormone. And people with social anxiety have a significant fear of rejection. A lot of times they don't have that warm, fuzzy feeling you get from oxytocin. When estrogen and testosterone are high, it affects the levels of things like serotonin and dopamine, norepinephrine and glutamate. So that can increase anxiety levels. So if you already have an underlying propensity for fear of being judged by others and your hormone levels are high, you may be more sensitive. During the periods when you're going nadal hormones tend to be higher. So interventions manage time effectively so you are not rushed or overwhelmed. When we are getting ready to go to a family gathering or even out on a date, it's important to manage our time. Because if we're rushed and we're feeling overwhelmed and pushed for time, guess what? Our HPA axis is already activated. We're already in that fight or fleet framework a little bit. We've already got high levels of cortisol, so we're already vulnerable to increases in anxiety. You want to start out anything that you've got to do as it pertains to social engagements. You want to make sure that you start out in a calm, grounded, centered state as much as possible. The next step is be prepared. Know what's expected of you when you're going. If you're trying out a new church or going to meet your boyfriend's parents or starting a new school, be prepared. Have your supplies that you need, whatever you might need. You know, in terms of school, for example, be prepared by knowing what to expect. A lot of people with social anxiety feel a lot more confident if they can visit those places ahead of time. If you. I remember when I was in college, before school would even start, I would go and find every single one of my classes that way. That first day, I knew where it was. I didn't have anxiety about getting there. So I, you know, I was really calm going in. I Was prepared. I always had a checklist of things I needed to bring with me. I'm big on checklists. You know, whether it's filling my gym bag or getting ready to go on a trip, I like to be prepared. And for me, checklists help a lot. But when you're prepared, that prevents getting into a situation and you know, part way through the situation, finding out that you don't have something you need or you're ill prepared. If you're going to a meeting, if you're going to give a presentation, make sure that you have your notes. And I always advise, have two copies of your notes, for example. So if you lose one copy or spill coffee on it or something, you have another copy. It's always good to have backups. Whenever I go to conferences, I always have a copy of my presentation on my laptop. I have a copy on a thumb drive and I also have a copy in the cloud that I can access should those other two fail. So I'm. I may be a little extra prepared, but that helps me feel calm before I go into these large events where I know people have expectations for what I'm going to say, how I'm going to behave, or what I'm going to do. Guided imagery and rehearsal are other interventions that can be really helpful when you are getting ready to go in front of people, imagining doing that, imagining asking somebody out, imagining going to this party or giving this presentation. Visualize it in your head. Visualize the entire area. Really try to use all your senses. What you see, what you hear, what you smell. You know, try to really put yourself in that situation and envision it going well. If you can go there ahead of time, you know, maybe you have to give a speech at an auditorium. If you can get to the, get into the auditorium the, a day or two beforehand and just walk up to where you're going to be and stand at the podium and imagine doing whatever you're doing. If you're going to ask somebody out, maybe you're going to ask them out. When you are in class or at a park or something, wherever you intend to do it, actually go there and just spend a few minutes envisioning doing it and envisioning it going well. Rehearse it, um, and you can rehearse it in your mind. You can also rehearse it with other people. A lot of people find it helpful to rehearse speeches, for example, so they don't have. So they know exactly what they're going to say and it feels a lot more natural to them, examine the facts and probability. A lot of people, when they're worried about being judged by others, they are thinking about or expecting sometimes the worst case scenario to happen. They're worried that their pants are going to fall down or they're going to accidentally, when they're talking, spit on somebody else or whatever they're envisioning, they're thinking of the worst case scenario. And it's important to really look at the facts. How likely is it for this to happen? You know, when I've given speeches before, even in smaller settings, have my pants fallen down? Well, probably not. If I wear a belt, will my pants fall down? Well, definitely probably not. So examine the facts that your worst fears are going to come true and is there any validity to that fear? And then what's the probability that that's going to happen? Could something happen? Sure. You know, anything can happen at any time, but how probable is it that something's going to happen? Another thing you want to do is examine the facts and the probability that people's reactions actually have to do with you. If you're in a situation where people are judging you, you know, is it, are they judging you as a human being or are they judging your performance? If you are interviewing for a job? Well, yeah, they're probably judging your performance. And it's important to separate what you do from who you are. Sometimes people are going to judge you because they're very unhappy with themselves and they feel a need to criticize and to kind of try to bring you down to, to where they feel they are. That's about them, that's not about you. People who are unhappy in themselves are going to find ways to be critical. And I don't mean constructively critical, I mean just critical. And it's important to recognize that. And recognize that has more to do with their own unhappiness and insecurities than you. They don't like seeing other people succeed when they don't feel like they are. So look at people's reactions and if somebody is being critical or if they're sitting out in the audience and they're giving you non verbals that don't look approving, well, it could be they've got a bellyache and you know, they're stuck there and they don't want to get up because that would disturb everybody. But they're not sure if they can sit through this whole thing. You've been there probably. So that could be one reason that somebody is giving you weird looks. People. I've had people in classes, people in conferences fall asleep. You know, how much of that had to do with me versus how much of that had to do with them. So I looked at their reactions, I considered how much of it, you know, I looked back at my stuff and I said, okay, was it kind of dry there? I looked at what everybody else was doing. And if one person's falling asleep and everybody else is attentive, then I can probably guess that that person didn't get enough sleep that night. Or they may not be interested in this topic. That doesn't have to do with me, that has to do with them. So facts and probability. What are the facts and probability that the worst case scenario is going to happen, what is most likely to happen and people's reactions? Because you will pick up non verbals, you will pick up non approving non verbals sometimes. And it's important to remember that people's reactions often have to do more with them than with you. Look at their reactions. You know, if I'm teaching a class and I see that half of my class is playing on their phone and you know, drifting off, then I know that I've probably belabored a topic for too long, so I need to move on. But it's important to remember that their reactions can have to do with their physical health. It can have to do with something that happened before they came in, maybe something they're dreading after this presentation, or it can have to do with their own self esteem and difficulty seeing someone else succeed. Number five, develop boundaries and assertiveness. Once you realize that people's reactions have more to do with them than you often develop those boundaries. If you feel like you're doing a good job, it's important to reinforce that with yourself. When you are interacting with other people. Developing emotional and cognitive boundaries is so important to help you feel confident. If they're having a bad day, you don't want that to seep into your emotions. So you're feeling that. So you're feeling that you are not doing such a good job. Sorry, I'm getting a bunch of trolls today. Get support, Find social buffers. It's always easier to deal with something when you've got support. When I defended my dissertation, it was anxiety provoking. And that was a small group. I love presenting, I love large groups, I love teaching. That wasn't that big of a deal. But going before my six person committee was really anxiety provoking because I knew they were going to be judging what I did. They weren't judging me so much as what I did and how I responded and what I knew. But it was really helpful to have my husband sitting in the background, you know, kind of cheering me on. So when I started feeling anxious, I, I could look to him and have a positive face that would encourage me and smile and nod or do something to say that, you know, you've got this. Keep going and silence your inner critic. Use thought stopping. If you're telling yourself you're going to bomb, people are going to hate you, your pants are going to fall down, whatever you're envisioning, use thought stopping. Tell yourself, no, that's not going to happen, things are going to go fine. I generally use thought stopping followed by, you know, that using that guided imagery again so I can see myself or I tell that voice in the back of my head, this is how it's going to go. You know, you are just, you know, trying to make me nervous. And, and again, when you're thought stopping, you're telling that person in your head, you're stopping those thoughts, you're saying, I'm not going to think that right now. And you can go so far as to actually backtalk it and say, no, that's actually not how it's going to go. Because I feel confident that I am prepared, I am ready for this, I've envisioned it, I've rehearsed it, and the probability of something bad happening is pretty small. Develop distress tolerance skills to reduce your fight or flight reaction and get into your wise mind. An acronym for that is is bats. Breathing Activities, Thought stopping and Sensations. The first step is breathing, and I say this a lot, I'll say it again. As you breathe, when you breathe in slowly and exhale slowly, you're triggering what they call the rest and digest, which is the opposite of fight or flee. So by slowing your breathing, that helps reduce your distress so you can think more clearly about whether there actually is a potential threat. Activities. Engage in activities that can help you not think about that. Whatever's coming up, that's anxiety provoking. If you're sitting there dwelling on it and you are, you know, up all night long rehearsing your speech that you've got to give it eight in the morning, you're going to be exhausted. It's important to prepare and then do something, do other things so you're not dwelling on all of the what ifs, thought stopping we already talked about. And sometimes sensations can help. If you're having a difficult time stopping those thoughts, splashing cold water on your face, holding ice cubes, doing 50 push ups, something that changes the focus of your mind to, to what is going on is really important. Reduce stimulants. Stimulants are going to increase cortisol, increase that HPA axis and make you a lot more vulnerable to an excessive stress reaction. So reduce stimulants before a social event that is causing you anxiety. Now remember, people with social anxiety tend to have anxiety most times when having to interact with others. People with situational anxiety, you know, obviously have an easier time reducing stimulants because it's, you know, going to do this speech or whatever. People with social anxiety often have anxiety about going to the grocery store and doing other things like that, so their anxiety is a lot more pervasive. Keep a log to identify your vulnerabilities, people, places, situations and physical status. Like if your blood sugar is low or if you are exhausted or if you're sick. Keep a log of those things so you can trace back and say, you know, I had a lot more anxiety when these things were, when all these ducks were in a row and develop a plan to address those things. If you know that your anxiety is a lot higher when you haven't got enough sleep and you are hyped up on caffeine, then guess what? Getting adequate sleep and not being overly hyped up on caffeine is going to be important. People that you're around. Sometimes being around, quote, authority figures can be anxiety provoking situations. Being in class, my daughter was recounting the other day about how they were in virtual class, but they were playing this game where they were like put on the spot really quick. And she knew the answers, but she couldn't come up with the right answer. She's like, I knew that. And as soon as I said the, said whatever I said, I knew it was wrong and I knew what the right answer was. And timed situations, time pressure situations really freak her out. So it's important for her to be aware that that's a problem and develop a plan to address those vulnerabilities. Stay in the present. Remember that bad situations don't have to repeat themselves. You may have had a bad incident when you were in high school giving a presentation, or maybe last week giving a presentation or, you know, I use presentations a lot. But at any situation that caused you anxiety, maybe you went to a friend's house and you felt really judged and it became, you know, a thing. It's important to remember that bad situations don't have to repeat. Look at what triggered your anxiety in that situation, what caused it to be quote, bad and figure out how to prevent that the next time. And remember, you do have some control over, over how you react and what you do in the future, but you don't have control of other people. It's important to remember that. Remember what I said about earlier. Sometimes people are so unhappy in their own head they are going to be judgy and critical because they don't, they can't stand to see other people happy or succeeding. Sometimes it's important to distance yourself a little bit from those people, compare yourself to others. You didn't think I'd put that one in there, did you? But it's true. Everybody makes gaffes and faux pas. We don't see the outtakes on a lot of the television shows we watch and the news shows we watch and, and other things, but people trip on their tongue. They make gaffes, they make faux pas. And it's important to remember that most people have done it. When I was working at one of the residential treatment center that I worked at, there was one time I used the restroom and we didn't have a staff restroom so I used the restroom up front, you know, by the check in desk and you know, did my thing, washed my hands, walked out, walked down the hallway, down through the residential wing and got all the way to my office before somebody pulled me aside and told me that I had tucked my dress into the back of my stockings. So you know, everybody in the clinic had seen my hiney who was out there and I was mortified. But it was important for me to recognize that, you know, everybody has moments and that one just would kind of be one of my, for my own personal record book was trying not to top it. But recognize that it happens. And sometimes making a gaffe or a frozen faux PA makes you seem more human. If you try to be perfect all the time, people may feel a little bit threatened around you because they know they make gaffs and faux pas. Identify your core beliefs and musts that contribute to your anxiety. Why is it so important that you think that everybody must approve of you at all, all times? You know, who told you that? What are your thoughts? What are your core beliefs about being around others and about the need for others approval and finally desensitization. Imagine situations that trigger your anxiety and practice breathing and thought stopping to get your anxiety level, to get your heart rate back down so you feel relaxed. Or once you can imagine it and not get completely freaked out, then take a step and maybe go to that place or near that place. So you're. You're actually seeing what's going on. And again, imagine being in there, being in that situation. Get to the point where you can do that without feeling completely freaked out, where you feel calm. And then eventually go into the situation, whether it's the grocery store or a classroom or wherever it is. Work on step by step getting to the place where you can actually expose yourself to the actual situation and feel confident that you have the tools to manage your anxiety in that situation. It's important to remember that is so using that anxiety, just saying, okay, that's all right. And anxiety is also sometimes can be confused with excitement because they both involve norepinephrine diagnosis. Introversion is a personality characteristic and it is a perfectly normal personality characteristic. So I'm not sure that any research has even been done on that for. There may be some out there on dopamine and social anxiety, but I have not looked at dopamine reuptake inhibitors on social anxiety. Covid makes things difficult because the social rules and expectations and public and the behaviors and reactions of other people are not currently consistent or normal. There's a lot of things that Covid has turned upside down and people are. A lot of people are under a lot of stress right now. So they are already in that fight or flight mode. So they tend to be more anxious, they may tend to be more defensive, and that may come off as more judgy sometimes. So that's important to recognize that when you're interacting with people right now, it may be a more negative interaction because they're already completely stressed out. Now Internet communications, like chat rooms, but even zoom to a certain extent and, and video chat create a situation called disinhibition where people will say things on the Internet that they would never dream of saying to your face. They are. They don't have that social filter on that says that's inappropriate. So people can be really hateful when they're talking to you online. And it's important to recognize again that that probably has a lot more to do with them than you. They may need a target for their anger at this point in time. Medications like SSRIs sometimes work and it's important to remember that medication pharmacotherapy or only works for about 30 to 35% of the population. The other part of the population may have some other underlying issue. It's. And medications in and of themselves rarely do the whole thing. They rarely completely, quote, fix the situation. It's important to remember that your thoughts, if you're having Stressful thoughts, it's going to throw your neurotransmitters out of whack. So no matter how much medication you're taking, if you're working against it with your thoughts and your behaviors, it may not be able to rebalance the system. There could also be underlying physical issues contributing to anxiety, such as hyperthyroid. It's always important to, for me to have my clients go and get a full blood panel done, get a full physical to make sure that there are no cardiovascular issues, their vitamins are in alignment with where they should be, and their hormones, including their thyroid, is where it should be. Because all of those things can contribute to anxiety. And when we have anxiety in situations, a lot of times our brain tries to find a reason for it. You know, why am I feeling anxious right now? And when you start looking for reasons, then you're going to notice more negative things. And you may attribute behaviors to, from other people to being judgmental or, or something else, and then you remember that as a bad situation and you start generalizing those, those reactions. So it is important to examine, you know, the triggers for the anxiety, examine when the anxiety, the social anxiety started, and you know what it means. There's a lot of things that counselors can help you work on to identify again those underlying core beliefs and that negative self talk that may be maintaining the anxiety. And they can help you recondition or decondition your overt anxiety response. And yes, social anxiety, social phobia, roughly the same. Social anxiety is identified in the DSM 5 and the DSMS before as a diagn diagnosable disorder. It is a psychological issue. And as with most issues, psychological or not, it has to do with the balance of neurotransmitters in your brain. And that can be organic because of brain injury or genetics, but it could also be because of thoughts or behaviors that you are doing or experiences that you've had that contribute to, you know, thoughts of unsafeness and disempowerment and need for external approval that maintain high levels of cortisol, high levels of glutamate, high levels of anxiety. Ag points out you should watch the blooper videos on YouTube from live newscasts. It can, it can be helpful to watch blooper reels from, from anything. But yeah, that's, that's great. You can go on YouTube and find some bloopers that you can go look, look back at. Social anxiety can start at any age. A lot of people start experiencing it in their high school years, in their teenage years, because I mean, High school is tough for everybody. And yes, social extroverts can have social anxiety too. Which again, remember that introversion is not a whoops. Is not a diagnosis, it's a personality characteristic. It's on the opposite end of the spectrum from extroversion. But that just means what kind of environments that you prefer that you thrive in. It doesn't necessarily mean you feel super anxious in any situation. It just talks about which environments help you recharge versus which environments drain your energy more. Very roughly, there are other things that it talks about. With children, it's important to be aware, just like with adults, when you're looking at the anxiety, what is triggering it? Is it developmentally appropriate? There is a period where little children are very shy. They will hide behind your. Hide behind your. Your leg and from strangers potentially. It's important to examine whether there are attachment issues because if a child is insecurely attached, they're probably a lot of times going to have a lot more anxiety. And then moving on to examine the extent to which their social anxiety is causing them impairment in their functioning. Is it keeping them from being able to go to school? Is it keeping them from being able to play with their friends and go to play dates? If so, then it's certainly worth taking the child to see the pediatrician and get the pediatrician to assess it. Well, in an actual session in response to Little Dancing Guy, you know, I'd really need a little bit more to go on to, To discuss what would be the next prompt because, you know, I start out with helping the person identify as I talked about, you know, triggers. Whoops. Keeping a log to identify their vulnerabilities, helping them identify their triggers. And then we go back and review situations in which they've had anxiety, whether it's coming into the clinic or going to the grocery store. And we talk about what their thoughts are that they're having that contributes to that anxiety. And then we drill down to core beliefs and musts that might be contributing to that. And we'll talk about that some. But we also at the same time work on developing distress tolerance skills so they feel like they can re regulate and get out of their emotional mind so they don't feel overwhelmed by their emotions. Then we move on to more examining facts and probability and guided imagery and rehearsal. Are there any other questions? I apologize for my brief pauses in here. I've been having to deal with a couple of particular, particularly unpleasant. Trolls. In terms of avoidant personality and social anxiety. There are some similarities, but it's also important to look at the other characteristics of avoidant personality disorder. A lot of people with avoidant personality have significant social anxiety, but very, I won't say very few, but it's a far smaller number of people who with social anxiety that have, that also have avoidant personality disorder. My understanding from the research is that social anxiety is a combination. As with everything of genetics and environment, people who tend to have more anxiety and tend to be, have more reactive stress symptoms tend to experience the environment as more threatening and therefore tend to develop social anxiety more frequently. But it's, you know, like everything with humans, it's a combination. All right, everybody, it seems like I've gotten through the questions and. Needing to. Keep addressing this, these particular trolls today. So what is the point where intervention is needed regarding social anxiety? Well, as I said at the beginning, my opinion is that it is never too early if you notice that things are causing you anxiety. It is never too early to start. Early intervention is always preferable. But when it starts causing significant disruption in your daily life is when it meets the criteria for official diagnosis in from the Diagnostic and Statistical Man Manual. But you know, I don't, I hate the fact that people think that they need to wait until it's absolutely disrupting their life before they start, you know, seeking help. Because there's so much we can do early on and just like addressing a cold or the flu early on, it's a lot easier and more effective to deal with before it starts permeating every aspect of your life. Alrighty everybody, have a great day and I will see you tomorrow.